The options in caring for premature ejaculation at present take several forms, from local anaesthetics and medicines acting on the central nervous system through to technologies designed to rebalance the nervous system and the pelvic muscles.
When comparing treatments for premature ejaculation in order to decide, what matters may not be "which option is best" but "which option suits the cause in each individual". This article compares the 4 main options clinically, so that the reader has enough information to consider together with a specialist physician.
An overview of the main options in caring for premature ejaculation
The options in caring for premature ejaculation can be divided into 2 broad approaches: the approach that helps suppress or delay the symptoms in the short term, and the approach that aims at rebalancing the mechanisms lying behind them.
Understanding this difference is an important starting point in choosing a suitable approach, because premature ejaculation does not always have a single cause. In some men the sensitivity of the nerves stands out; in others it involves pelvic muscles that work over-actively; and in others there may be other co-existing states that should be assessed at the same time.
Topical Numbing Agents
Topical numbing agents work by temporarily reducing the sensitivity of the skin and the nerves around the genitals, applied or sprayed on before sexual intercourse.
The advantage is that they are easy to begin with and take effect quickly. The point to consider is that this is a temporary suppression of the symptoms; it does not correct the cause lying behind them, and some men may feel that the sensation during sexual intercourse is reduced too much.
Topical numbing agents may suit use as a supporting option in some situations. However, the choice to use them should be under a doctor's advice.
Medicines acting on the central nervous system (SSRI)
Certain medicines in the SSRI group have an effect on the central nervous system, and may have a side effect that helps delay the timing of ejaculation. In some contexts they are therefore used as part of a plan of care for premature ejaculation.
The advantage is that they act directly on the central nervous system. The point to consider is that there may be other side effects that must be assessed, and they do not directly correct the mechanism of the pelvic muscles.
The use of this group of medicines must be under the consideration and prescription of a doctor alone, particularly in those with underlying conditions, taking regular medication, or with other co-existing states that may affect the suitability of the treatment.
Focused Shockwave Therapy (f-ESWT)
Focused Shockwave Therapy (f-ESWT), or low-energy focused shockwave, is a technology using sound-wave energy to reduce the sensitivity of the peripheral nerves (Neuromodulation), where the cause of the premature ejaculation involves over-sensitive sensory nerves.
Besides this, Focused Shockwave also has a part in stimulating the formation of new blood vessels where erectile dysfunction is also present.
The advantage is that it is an approach aiming at rebalancing the nervous system rather than merely suppressing sensation temporarily. The point to consider is that it has to be done continuously as a round of care, and its suitability depends on the character of the cause assessed in each individual.
PMS Biofeedback
PMS Biofeedback is a magnetic technology that stimulates the contraction of the pelvic muscles at the highest level, together with a Biofeedback system that helps the person receiving care see and understand the working of their own muscles.
This approach suits premature ejaculation with a basis in pelvic muscles that work over-actively, or that control the rhythm of contraction and release insufficiently well.
The advantage is that it helps train control that is natural and does not depend on medication. The point to consider is that it depends on continuity, and its suitability depends on the cause in each individual; PMS Biofeedback is not the main answer on its own in every case.
The comparison in terms of the cause of the symptoms
When the options are compared in terms of mechanism, it can be seen that each option has a different part to play.
Topical numbing agents and SSRIs aim at helping suppress or delay the mechanism of ejaculation, while Focused Shockwave and PMS Biofeedback aim at rebalancing the nervous system and the muscles that are the origin of the symptoms.
In many men, the most comprehensive plan of care may not be the choice of a single method, but the combination of several approaches according to the result of the assessment, giving importance above all to the cause that is found.
The factors that should be considered when choosing an approach
Before deciding to choose any one option, several factors should be considered together, namely the character and the severity of the symptoms, the presence of co-existing states such as CPPS or erectile dysfunction, the intention of the person receiving care as regards the length of time, and the goal of the care, such as wanting to suppress the symptoms temporarily, or aiming at rebalancing in the long term.
A suitable decision should therefore arise from a medical assessment complete in every dimension, not from comparing only the advantages and disadvantages of each option separately.
The approach to care at PYONG MEN
At PYONG MEN the plan of care for premature ejaculation is designed according to the result of the assessment for the individual. The approach may consist of using Focused Shockwave to reduce the sensitivity of the nerves, using PMS Biofeedback to train the control of the rhythm of the pelvic muscles, and assessing an inflammation in the pelvis that may be hidden.
A plan of care complete in every dimension helps the care match the cause in each individual more closely, instead of choosing one method or another from the symptoms alone.
In brief
- The options in caring for premature ejaculation divide into the symptom-suppressing kind (topical numbing agents, SSRIs) and the rebalancing kind (Shockwave, PMS Biofeedback)
- Topical numbing agents and SSRIs act quickly, but do not correct the cause lying behind the symptoms
- Focused Shockwave aims at reducing the sensitivity of the peripheral nerves
- PMS Biofeedback suits those whose pelvic muscles work over-actively
- Choosing a suitable approach depends on the cause in each individual and on a medical assessment complete in every dimension
Frequently asked questions (FAQ)
1. Which option is best for premature ejaculation? There is no option that is best for everyone. Suitability depends on the cause assessed, and in many men the comprehensive plan of care is usually a combination of several approaches.
2. Is it wrong to use a topical numbing agent? A topical numbing agent is a temporary suppression of the symptoms; it does not correct the cause lying behind them. Its use should be under a doctor's advice, and it may suit use as part of an overall plan of care.
3. Do SSRIs suit everyone? Not always. The use of an SSRI must be under the consideration and prescription of a doctor, and the side effects that may arise in other respects must be assessed alongside.
4. Can Focused Shockwave and PMS be used in place of one another? It is not a matter of using one in place of the other; they are forms of care aiming at correcting different mechanisms. Many men use both together according to the result of the assessment.
5. How long does the care take? A plan of care is generally in the range of 2–3 months. The exact length of time depends on the cause and the response of each individual.